Wolters Kluwer Health
may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
your express consent. For more information, please refer to our Privacy Policy.

Background: The internal mammary artery perforator flap is a versatile flap used for reconstruction of the head and neck. Using dissection, angiograms, and three-dimensional reconstruction, the authors describe the vascular anatomy of the internal mammary perforator arteries, including their course, diameter, location of perforation, and relationship to other tissues (e.g., bone, muscle, and skin).

Methods: Fourteen fresh cadavers were injected with either latex or a lead oxide/gelatin mixture and dissected to show the anatomy of the internal mammary artery perforators. Plain film and computed tomographic angiograms were obtained and analyzed on the lead oxide–injected cadavers. The computed tomographic angiography Digital Imaging and Communications in Medicine images were imported into Materialise's Interactive Medical Imaging Control System software to produce three-dimensional reconstructions of the internal mammary artery perforator anatomy.

Results: The second internal mammary artery perforator was the dominant perforator in 10 of the 14 cadavers. The mean emerging diameter of the dominant second perforator was 1.0 ± 0.4 mm, with a mean superficial length of 51.8 ± 16.1 mm on the latex-injected and lead oxide–injected cadaver angiograms. The mean distance from the sternal margin to the point of emergence from the internal mammary artery was 7 ± 1.4 mm. The three-dimensional reconstructions demonstrated anastomoses between the dominant perforator and the lateral thoracic artery.

Conclusions: The vascular anatomy of the internal mammary artery perforators was documented using cadaveric dissections, angiograms, and computed tomographic angiograms analyzed with Materialise's Interactive Medical Imaging Control System. The diameter, point of perforation, course, and relationship to surrounding anatomical structures has been shown using a vascular injection technique and three-dimensional reconstructions.

SUPPLEMENTAL DIGITAL CONTENT IS AVAILABLE IN THE TEXT.

Halifax, Nova Scotia, Canada

From the Department of Anatomy and Neurobiology, Dalhousie University.

Received for publication January 15, 2011; accepted May 16, 2011.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Supplemental digital content is available for this article. A direct URL citation appears in the printed text; simply type the URL address into any Web browser to access this content. A clickable link to the material is provided in the HTML text of this article on the Journal's Web site (www.PRSJournal.com).

Some error has occurred while processing your request. Please try after some time.

Email to a Colleague

Colleague's E-mail is Invalid

Your Name: (optional)

Your Email:

Colleague's Email:

Separate multiple e-mails with a (;).

Message:

Send a copy to your email

Your message has been successfully sent to your colleague.

Some error has occurred while processing your request. Please try after some time.

Add Item(s) to:

An Existing Folder

A New Folder

Folder Name:

Description:

The item(s) has been successfully added to "".

David H. Song, M.D., M.B.A. is the President-elect of the American Society of Plastic Surgeons (ASPS). He is a consultant with BioMet, Emmi Solutions, LLC, a consortium-member providing senior debt for Brava, and consultant with and investor in HealthEngine.com. He receives author royalties from Elsevier. Scot Glasberg, M.D. is the President of the American Society of Plastic Surgeons (ASPS). He is a consultant with LifeCell Corp and Mentor Corp and an investor with Strathspey Crown. The authors have no sources of funding to report related to the writing or submission of this discussion.

The location and affiliation information should read as follows: Arlington Heights, Ill. From the American Society of Plastic Surgeons/Plastic Surgery Foundation.